Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 20501 | PR |
NPI | 1003224841 |
---|---|
Provider Name | Mrs. Elizabeth Abella |
First Address | Catano, PR 00963-0282 |
Second Address | Catano, PR 00962-4877 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2014 |
Last Update Date | 24/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
20501 | SW LICENSE (01) | PR |